High-dose Bendamustine-EAM followed by autologous stem cell rescue results in long-term remission rates in lymphoma patients, without renal toxicity.

Abstract

BACKGROUND:

Autologous stem cell transplantation (ASCT) following BEAM (BCNU, etoposide, cytarabine, melphalan) conditioning is standard of care in relapsed low- and high-grade B-cell lymphoma (DLBCL) and other lymphoproliferative disorders, but BCNU is associated with interstitial pneumonia and an increased mortality. A less toxic regimen might improve the outcome of patients with lymphoma after transplantation.

OBJECTIVES:

We investigated the role of bendamustine replacing BCNU in the BEAM regimen in patients with lymphoma undergoing ASCT.

PATIENTS/METHODS:

The conditioning regimen BendaEAM consisted of bendamustine, cytarabine, etoposide, and melphalan and was used in patients with Hodgkin's disease (HD) and Non-Hodgkin lymphoma (NHL).

RESULTS:

Forty-one patients with HD (n = 9) or NHL (n = 32) were consecutively treated with Benda-BEAM replacing BCNU. No pulmonary or renal toxicities occurred, and no patient died related to transplant. After a median follow-up of 55 months, CR rate was 56%, 18 patients (44%) showed progression after a median time of 7 months after transplantation (range: 2-29 months), and 11 patients (24%) have died, all due to lymphoma progression. The 1-, 2-, and 4-year PFS are 73.2%, 58.6%, and 55.6% and the 1-, 2-, and 4-year OS 85.4%, 78.0%, and 72.6%, respectively.

CONCLUSION:

BendaEAM seems to be feasible with a promising response rate and acceptable toxicity.

• Authors: Thomas Noesslinger, Michael Panny, Ralph Simanek, Michaela Moestl, Alexandra Boehm, Elisabeth Menschel, Elisabeth Koller, Felix Keil
• Journal: European journal of haematology (Eur J Haematol) Vol. 101 Issue 3 Pg. 326-331 (Sep 2018) ISSN: 1600-0609 [Electronic] England
• PMID: 29799642 (Publication Type: Journal Article)
• Copyright: © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Cytarabine
• Etoposide
• Bendamustine Hydrochloride
• Melphalan
• Carmustine

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Bendamustine Hydrochloride (administration & dosage)
• Carmustine (adverse effects, therapeutic use)
• Combined Modality Therapy
• Cytarabine (adverse effects, therapeutic use)
• Etoposide (adverse effects, therapeutic use)
• Female
• Hematopoietic Stem Cell Transplantation (adverse effects, methods)
• Humans
• Lymphoma (diagnosis, mortality, therapy)
• Male
• Melphalan (adverse effects, therapeutic use)
• Middle Aged
• Survival Analysis
• Transplantation Conditioning
• Transplantation, Autologous
• Treatment Outcome
• Young Adult